Form Mllc-11c - Limited Liability Company Certificate Of Cancellation
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1Filing Fee $75.00
LIMITED LIABILITY COMPANY
STATE OF MAINE
CERTIFICATE OF CANCELLATION
(for a Maine LLC)
_____________________
Deputy Secretary of State
A True Copy When Attested By Signature
______________________________________
_____________________
(Name of Limited Liability Company)
Deputy Secretary of State
Pursuant to
31 MRSA
§1533.2, the undersigned hereby executes and delivers the following certificate of cancellation:
FIRST:
The date the limited liability company’s original certificate of formation was filed: ____________________________
SECOND:
The limited liability company is dissolved and the date of dissolution (if known) is: _____________________________
THIRD:
The effective date of the cancellation shall be (Please check one):
the date of filing of this certificate or
the future effective date as follows: ___________________________________________
(Notice: upon filing this Certificate, the limited liability company shall be removed from the active
records of the Secretary of State.)
FOURTH:
Any other information the person filing the certificate of cancellation determines necessary, if any, is set forth in Exhibit
_____ attached and made a part hereof.
*Authorized Signature(s)
DATED ____________________________________________
___________________________________________________
____________________________________________________
(signature)
(type or print name and capacity)
___________________________________________________
____________________________________________________
(signature)
(type or print name and capacity)
**Pursuant to
31 MRSA §1676.1.B
or
31 MRSA
§1676.1.C, this document MUST be signed by a person authorized by the limited liability
company or if filed on behalf of a dissolved limited liability company that has no members, this document must be signed by the person
winding up the limited liability company’s activities under
31 MRSA §1597.1
or a person appointed under section
31 MRSA
§1598.2.
The execution of this certificate constitutes an oath or affirmation under the penalties of false swearing under
17-A MRSA
§453.
Please remit your payment made payable to the Maine Secretary of State.
Submit completed form to:
Secretary of State
Division of Corporations, UCC and Commissions
101 State House Station
Augusta, ME 04333-0101
Telephone Inquiries: (207) 624-7752
Email Inquiries:
CEC.Corporations@Maine.gov
Form No. MLLC-11C 7/1/2011
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